الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 121 |  |  |
| | | from | 121 | | |
Abstract
The goals of neuro-anesthesia are providing good operating conditions and ensuring stable cerebral hemodynamics. During recovery, abrupt increases in arterial blood pressure can pose a risk for postoperative hematoma. Moreover, fast recovery from anesthesia is often preferred to allow immediate neurological evaluation.
Alpha2-Adrenergic agonists as dexmedetomidine has been introduced to clinical anesthesia for their sympatholytic, sedative, anesthetic sparing and hemodynamic stabilizing properties. Dexmedetomidine is increasingly used as an anesthetic adjuvant because of its analgesic properties, cooperative sedation, and lack of respiratory depression.
This study was undertaken to assess and compare the hemodynamic and recovery responses to extubation after intravenous injection of study drugs (dexmedetomidine and nitroglycerine) in intracranial surgery.
Two groups of dexmedetomidine & nitroglycerine were made. Thirty patients, of ASA I & II were involved in each group. Patients received I.V dexmedetomidine in maintenance rate 0.1– 0.7 µg/Kg /hour just before closure of the dura & till the end of surgery. The same for the N group, as patients received I.V nitroglycerine in maintenance rate 1-6 g/Kg/min.
All patients were recorded after the start of the drugs (at 1, 3, 5, 10, 20 and 30 min after drug intake) and around extubation (1min before extubation, at extubation, 1min, 3min, 5min, 10min, 20min and 30 min after extubation) for hemodynamic variables (Systolic, diastolic and mean arterial pressure, heart rate, arterial oxygen saturation and end tidal CO2 concentration). Also time to full recovery among the two groups was recorded.
As regards results during extubation, our results demonstrated that the patients of the D group had significantly lower values as regards SBP, DBP, MAP and HR starting from the end of surgery till the 30 minutes after extubation, and so it gave better hemodynamic responses during extubation compared to the patients of the N group but with higher HR.
There was no clinical difference between dexmedetomidine & nitroglycerine in the control of the blood pressure (SBP, DBP & MAP) but, there was difference between their effects on the HR starting from the end of surgery till the 30 minutes after extubation. Also there was no clinical difference between them in the effect on Etco2 & SPO2 but there was a difference on the recovery time.